And opera needs works like “10 Days,” which treats the medium with affection and respect while also chafing at its tropes throughout history. This adaptation of Nellie Bly’s 19th-century journalistic report of the same name questions the nature of madness — and who has the authority to identify it — in an art form that subjects its heroines to many of the same horrors that Bly witnessed on Blackwell’s Island (now Roosevelt Island), where she was undercover, feigning mental illness to be briefly institutionalized.

Orth’s score has its problems. Its use of electronics can come off as dated, and its musical shorthand for insanity and dread — jittery phrasing, ghostly choruses — verges on the parodic and cliché. At its best, though, it captures a tension that has long made opera unsettling, the way in which, say, a mad scene can be a thing of shattering beauty and breathtaking athleticism, but also one of undeniable misogyny.

For this is an opera that jerks between beauty and terror — seamlessly under the baton of Daniela Candillari, leading an ensemble of about a dozen instrumentalists. The patients (members of Opera Philadelphia Chorus, led by Elizabeth Braden) can sing the same hymn with serenity in one scene and chaotic dissonance in the next, with few indications of which is the truer rendition. The villain, Dr. Josiah Blackwell, performed by the baritone Will Liverman with frightening warmth, is given a gentle melody over an unstable waltz that shifts from 3/2 to 2/2 time and back again.

Joanna Settle’s production at the Wilma Theater unfolds around a unit set by Andrew Lieberman, a cylinder cut into quadrants by two intersecting hallways, which over the opera’s 90 minutes begins to feel appropriately unvarying and confined. In this space, Bly — the soprano Kiera Duffy, her bright sound adding alarm to her role’s lyricism — encounters women who are less insane than their diagnoses, and a nurse (Lauren Pearl, an indelible presence with limited vocal material) who seems just as agonized as them.

The most tragic of the patients is Lizzie (the mezzo-soprano Raehann Bryce-Davis, who sings with a lush and moving elegance that would make her ideal for mid-20th century American opera). Her repetitive ramblings come into logical focus with a long, crushing aria about the death of her daughter. You come to realize, frustratingly, that, like the Chinese woman declaring her sanity in a language no one else can understand, or like Bly herself, Lizzie doesn’t belong there. She’s only grieving.

In a score of dance-beat non sequiturs and eclecticism, her aria was a testament to the power of a directly pleading, flowing melody — the kind of music you get out of more traditional fare like Verdi’s “Boccanegra,” which opened at the Academy of Music on Friday evening.

Joshua Barone

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